THE PREPAREDNESS OF THE NIGERIAN HEALTH SECTOR IN THE ERA OF RE-EMERGING DISEASES

Cicero Oratory Competition is an annual public speaking contest for medical students of University of Ibadan. I partook in the contest for this year, and the piece below was my speech at the finals. Enjoy!

Sixty years ago, many people in the world believed the age-old battle of humans against infectious diseases was almost over, with mankind gradually winning. However, the events of the past three decades have shown that we have only been joking. At least a dozen “new” diseases have been identified, such as AIDS and Legionnaire disease, and traditional diseases that appeared to be “on their way out”, such as malaria and tuberculosis, are still thriving in Nigeria.

Ladies and gentlemen, I hate to admit it, but you should know that, in preparation for this oratory contest, I have not only had sleepless nights; I have also lost weight. And the reason is not far-fetched: I have had a difficult time in explaining to my friend in Faculty of Agriculture what the topic of this contest means. “The Preparedness of the Nigerian Health Sector in the Era of Re-emerging Diseases”. Pff! Quite a mouthful topic, you would agree.

But simply, as defined by National Center for Biotechnology Information, re-emerging diseases are such diseases that once were major health problems globally or in a particular country, were brought under control, declined dramatically, but are again becoming health problems for a significant proportion of the population. Examples are cholera, AIDS, meningitis, influenza, and, of course, the recent sensational Ebola and Lassa Viral Diseases. When I told my friend that malaria was also on the list, he laughed and said, “Ma-la-ria. Ni-ge-ria. Can’t you see they rhyme? My man, forget it, malaria is already a citizen of Nigeria.” Whether that is witty or not, I can’t say, but it sure goes a long way to tell you what people think of Nigeria and the state of our health sector.

Nigeria’s Minister of Health, Professor Isaac Adewole, in the 69th World Health Assembly held earlier this year in Geneva, Switzerland, emphasized the need for awareness creation on re-emerging diseases. This was reported by Vanguard newspaper on May 26, 2016. So far, it is common knowledge that the Ministry of Health and other health agencies in Nigeria have not been maximizing the potentials of technology and social media in creating mass awareness and grassroot sensitisation. Hence, it is no surprise that Nigerians have been suffering from inadequate health education, maladministration and misinformation. The sorry case of bathing with salty water in late 2014 that sent more people to their early graves than the dreaded ebola itself did comes readily to mind. If anything, Neil Gaiman, the author of ‘The Graveyard Book’, was right when he said, “Fear is contagious. You can catch it.”

I should like to tell you about my fat cousin whose knee became stiff, having complained of swelling and pain around it. Instead of visiting a hospital, his parents decided to take him to a pastor. The pastor said it was the work of the devil, more like a spiritual arrow from the enemy. A pity my cousin couldn’t dodge a common arrow. So, they prayed and fasted, casting and binding every evil spirit from our village. But the knee remained stiff and swollen. As a last resort, the parents reluctantly took him to a hospital, where the knee was x-rayed and he was diagnosed with osteoarthritis. He got a knee brace, drugs and ointments. A week after, my cousin was back on his feet again, swaggering about and chasing around the ladies in his neighbourhood.

This story, in many ways, captures a major challenge of the health sector as regards the disposition of average citizens towards health services. And without the cooperation of the citizens, it is impossible to meaningfully combat re-emerging diseases. Cultural beliefs, religious beliefs and hygiene practices form the people’s way of life, and the health sector must be prepared to fashion its services to suit these intricacies.

Pro-active, reactive, inactive — beautiful rhymes, not so? Sounds like what Desiigner, the crooner of the Panda-panda legend, would say, not so? But more importantly, these three rhyming words also describe health sectors of different countries. Pro-active countries anticipate dangers and design mechanisms in order to combat future health challenges. Reactive ones wait for disaster to strike before they move and try to contain the situation. One doesn’t need a degree in Epidemiology from an Ivy League college to know that, when it comes to diseases in Nigeria, the term “preventive measure” is as hopeless as having electricity in University of Ibadan after 11.00PM.

On October 20, 2014, the World Health Organisation declared that Nigeria was totally free of Ebola. We patted ourselves on the back and jubilated. We had defeated the monster, and that was all. Nobody asked what institutional capacities had been built to contain future emergencies. Nobody asked if we seized the opportunity Ebola presented to build a strong National Centre for Disease Control. These are the questions Chikwe Ihekweazu, a consultant epidemiologist and the editor of Nigeria Health Watch, insists that we must now ask. Although it is said that the populace has a short term memory, we couldn’t have forgotten so soon how Lassa virus reared its ugly head earlier this year, dealing us the highest fatality ratio since the virus was discovered in Lassa town, Borno, in 1969. How could this disaster happen on the heels of the euphoric victory over Ebola? Didn’t our health sector pick anything from the Ebola saga to equip them for Lassa and other such future epidemics?

While the Nigerian health sector deserves some commendations for its past successes, we cannot ignore the fact that we still have a long way to go. The former Minister of Health, Professor Onyebuchi Chukwu, admitted in May 2012 that malaria was the cause of 30% child death in Nigeria. In a survey conducted by United States Embassy in 2011, it was established that HIV kills 215,000 Nigerians annually. With these disturbing figures, ladies and gentlemen, if you say our health sector is prepared for re-emerging diseases, I, Omoya Simult Omoya, will laugh, look you dead-straight in the eyes and ask you to tell me another joke.

Good afternoon.

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